An outpatient treatment strategy designed to help persons who are
addicted to drugs stop using them. Commonly used in association with
the medical treatment of cocaine abuse.
Acute abstinence syndrome:
The aggregate of withdrawal signs and symptoms that occur shortly
after a person who is physically dependent on a drug stops taking it.
The adjective "acute" distinguishes this variant from the "protracted"
or "chronic" drug withdrawal or abstinence syndrome.
Acute psychosis:
A disturbance in thinking that is often accompanied by delusions and
visual or auditory hallucinations. An acute psychosis may be caused by
alcohol or other drug (AOD) withdrawal, drug toxicity (most commonly in
conjunction with abuse of cocaine, methamphetamine, or psychedelic
agents), or schizophrenia.
Analgesia:
Relief from pain.
Anhedonia:
Absence of pleasure from acts that would ordinarily be
enjoyable.
Anorexia:
Diminished appetite; aversion to food.
Arthralgia:
Joint pain.
Ataxia:
Unsteady walking or staggering, caused by an inability to coordinate
the muscles.
Authorizing order:
An order issued by a court that permits an AOD abuse treatment
program to make a disclosure about a patient that would otherwise be
forbidden.
Cellulitis:
Inflammation of the cellular or connective tissues.
Chronic obstructive pulmonary disease:
A combination of chronic bronchitis and emphysema. Characterized by
persistent disruption of the flow of air in and out of the lungs.
Clouded sensorium:
Confusion.
"Cold turkey":
Popular term used to describe the process of opiate withdrawal that
is not treated with medication. During withdrawal, the person's skin is
covered with goose bumps and resembles that of a turkey.
Decisional capacity:
The ability of a patient to make an informed choice.
Delirium:
A state of mental confusion characterized by difficulty in
responding to stimuli and an absence of orientation to place and time.
May be accompanied by auditory, visual, or tactile hallucinations. May
be caused by drug withdrawal or severe intoxication with
phencyclidine.
Delirium tremens:
A severe form of alcohol withdrawal characterized by confusion,
auditory or visual hallucinations, and severe shakiness. Commonly
called "DTs."
Delusions:
Fixed, irrational ideas not shared by others and not responding to a
logical argument.
Diaphoresis:
Profuse sweating that is not in response to high temperature or
exercise. A common symptom of opiate or sedative-hypnotic withdrawal.
Disclosure:
A "communication of patient-identifying information, the affirmative
verification of another person's communication of patient-identifying
information, or the communication of any information from the record of
a patient who has been identified" (42 C.F.R. '2.11).
Drug receptors:
Specialized areas on the surface of brain cells to which drugs
attach and through which they produce their effects.
Drug tolerance:
The body's ability to endure increasing quantities of a drug. As
the brain cells adapt to the presence of a drug, more of the drug is
required to produce the same effect.
Dual diagnosis:
The presence of both an AOD abuse problem and a psychiatric
disorder.
Duty to warn:
The legal obligation of a health care provider to notify
law-enforcement officials or the potential victim when a patient
presents a serious danger of violence to an identifiable
individual.
Dysphoria:
An unpleasant mood.
Electrolytes:
Compounds in the blood that conduct electricity and can be
decomposed by it. They include, for example, sodium, potassium, and
chloride ions. Electrolyte imbalance can be caused by protracted
vomiting, diarrhea, or dehydration. It also may result from failure to
administer the correct type or quantity of intravenous fluids.
Encephalopathy:
Any disease or disorder that affects the brain.
Grand mal seizures:
A type of seizure in which a person falls to the ground unconscious
and suffers generalized muscle contractions. The person usually remains
unconscious for a time and may have no recall of the episode on
awakening. Petit mal seizures, by contrast, are characterized by
a momentary loss of awareness; an observer may think the person
experiencing the seizure is simply daydreaming.
Hyperpyrexia:
Extremely high fever.
Hyperreflexia:
An exaggerated response of muscle reflexes that indicates that the
nervous system is in a pathologically excited state. May occur during
withdrawal from sedative-hypnotic agents or alcohol.
Hypertension:
Abnormally high blood pressure. Usually defined as a resting blood
pressure greater than 140 mm hg (systolic) and 90 mm hg
(diastolic).
Involuntary commitment:
Process by which patients who have not committed any crime are
brought into treatment against their wishes by relatives or the police
or through a court proceeding. Involuntary commitment is also known as
"protective custody" or "emergency commitment."
Medical comorbidity:
Presence of two serious illnesses at once; for example, drug
addiction and acquired immunodeficiency syndrome.
Medical emergency:
A condition that poses an immediate threat to the health of any
individual and that requires immediate medical intervention (42
C.F.R.).
Medically debilitated:
Term used to describe an individual who is both AOD-dependent and
who has a chronic or severe medical disease such as emphysema.
Medication discontinuation:
The process through which therapeutic doses of a prescribed
medication are tapered or withdrawn. Detoxification, by contrast,
refers to discontinuation of the use of an illicit drug or a
self-administered prescription medication.
Myalgia:
Muscle pain. A common complaint during opiate withdrawal.
Narcotic-dependent:
(Federal methadone guidelines): Term used to describe an
individual who physiologically needs heroin or a morphine-like drug to
prevent the onset of signs of withdrawal.
Narcotic treatment program:
According to Federal methadone guidelines, an organization (or a
person, including a private physician) that administers or dispenses a
narcotic drug to an addict for maintenance or detoxification treatment;
provides, when appropriate or necessary, a comprehensive range of
medical and rehabilitative services; is approved by the State authority
and the Food and Drug Administration; and is registered with the Drug
Enforcement Administration to use a narcotic drug for the treatment of
narcotic addiction.
Network treatment:
"An approach to rehabilitation in which specific family members and
friends are enlisted to provide ongoing support and to promote attitude
change. Network members are part of the therapist's working 'team' and
not subjects of treatment themselves" (Galanter, 1994).
Neuroadaptation:
The process by which the function of the brain cells changes in
response to exposure to drugs. These adaptive changes may include
increases in the number of receptor sites, alterations in the shape of
the receptors, or changes in the chemical functioning of the cell.
Nonmalignant pain:
Chronic pain that is not caused by cancer. Also called "chronic
benign pain."
Nystagmus:
A jerky movement of the eyes. May be seen in persons who are
intoxicated as a result of ingestion of alcohol, sedative-hypnotic
agents, or phencyclidine.
Orthostatic hypotension:
A rapid drop in blood pressure (usually defined as 10 mm hg or
greater) that occurs when a person stands up. Such an individual may
become dizzy or even faint. May be a sign of sedative-hypnotic
withdrawal or opiate intoxication. Also called "postural
hypotension."
Pancreatitis:
Inflammation of the pancreas. Alcohol abuse is the most common
cause of chronic pancreatitis and a principal cause of acute
pancreatitis.
Paresthesia:
An abnormal burning, pricking, tickling, or tingling sensation.
Patient-identifying information:
The "name, address, social security number, fingerprints,
photograph, or similar information by which the identity of a patient
can be determined with reasonable accuracy and speed, either directly or
by reference to other publicly available information . . . " (42 C.F.R.
'2.11).
Pentobarbital challenge:
A method of assessing physical dependence on alcohol or other
sedative-hypnotic agents. The challenge consists of administering
standard doses of pentobarbital to a patient and observing the effects.
Patients who become intoxicated on 200 mg or less of pentobarbital do
not have substantial tolerance to sedatives and are presumed not to be
physically dependent on these substances.
Physical dependence:
A condition in which the brain cells have adapted as a result of
repeated exposure to a drug and consequently require the drug in order
to function. If the drug is suddenly made unavailable, the cells become
hyperactive. The hyperactive cells produce the signs and symptoms of
drug withdrawal.
Protracted abstinence syndrome:
The aggregate of signs and symptoms of drug withdrawal. These signs
and symptoms may continue for weeks or months after cessation of drug
use. (Also see "acute abstinence syndrome.")
Record:
"Any information, whether recorded or not, relating to a patient
received or acquired by a Federally assisted alcohol or drug program"
(42 C.F.R. '2.11).
Recrudescence:
Reappearance of symptoms after a period of remission.
Relapse prevention:
In common usage, any strategy or activity designed to assist a drug
user who has become abstinent from returning to drug use. Relapse
prevention also refers to specific cognitive-behavioral treatment "that
combines behavioral skill-training procedures with cognitive
intervention techniques to assist individuals in maintaining desired
behavioral changes." It draws from both health psychology and
social-cognitive therapy and uses a "psychoeducational self-management
approach to substance abuse designed to teach patients new coping
responses (e.g., alternatives to addictive behavior), to modify
maladaptive beliefs and expectancies concerning substance abuse, and to
change personal habits and lifestyles" (Marlatt and Barrett, 1994).
Signs:
Observable or measurable changes in a patient's physiology; for
example, increased blood pressure or dilated pupils. Such changes may
not be perceived by the patient.
Somnolence:
Sleepiness, drowsiness.
Symptom rebound:
Transient, intensified return of symptoms following termination of
therapeutic doses of a benzodiazepine. The most common withdrawal
consequence of prolonged benzodiazepine use.
Symptoms:
Subjective changes in mood, feelings, or bodily sensations.
Tachycardia:
Rapid heartbeat (generally more than 100 beats per minute).
Therapeutic dosage:
The amount of a drug required to produce a beneficial effect.
Triage:
Process by which patients are assessed to determine the type of
services and level of care they will require.
Up-regulation:
An increase in the number of receptors on the brain cells that is
caused by continuous contact with drugs.
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